Dr William Borden Discusses MACRA Requirements From a Cardiologist's Perspective

As CMS developed the Medicare Access and CHIP Reauthorization Act (MACRA) over the past few years, it was responsive to the needs and concerns of clinicians, according to William Borden, MD, FACC, FAHA, associate professor of medicine and director of healthcare delivery transformation at the George Washington University. Still, Borden says there are ways the requirements could be simplified, which would benefit both physicians and patients.

Transcript (slightly modified)Do you think that CMS took the physician perspective into account when developing MACRA?
I do think so. I think specifically with the final rule that came out this past fall, there was a lot of physician input. There was a lot of concern about small and rural practices and the speed at which MACRA’s being rolled out. CMS was responsive to that and instituted the pick your pace policy at least for 2017, and so I think that it’s definitely being responsive and looking at providing tools for providers to allow them to be successful.

I think there are still some remaining issues. I think that small and rural practices as they look to 2018 still have some concerns. The availability of APMs for a variety of providers including cardiologists is an issue. And then I think the flexibility and availability of the EHRs to really provide the data feedback that’s necessary to be successful in these programs, these are all areas where there is provider input and I think that there still remain some opportunities.

If you could change anything about the MACRA requirements, what would it be?
If I could change 1 thing about MACRA, I think it would be around simplifying the quality measures. There’s still a substantial amount of time when face to face with the patient, with the physicians after that time, with administrative staff in trying to meet these quality measures, so I think simplifying or reducing the administrative burden. And then also continuing, which Medicare has done, in moving towards more outcome measures and measures that are truly meaningful for the outcomes our patients care about.